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An in-depth understanding of the methods used for estimating glucose levels in serum, plasma, and CSF, focusing on the enzymatic method. It explains the principles behind the test, the procedure for estimating glucose concentration, and the clinical interpretation of results. Additionally, it covers the Glucose Tolerance Test (GTT), its types, indications, procedure, and clinical significance.
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Introduction: There are different methods to estimate the blood glucose (1) Orthotoluedene Method (2) Enzymatic Method Principle of the Enzymatic Method In this test, glucose is oxidized to gluconic acid and hydrogen peroxide in the presence of glucose oxidase (GO). Hydrogen peroxide further reacts with phenol and 4 −aminoantipyrine by the catalytic action of peroxidase (PO) to from a red colored quinoneimine dye complex. Intensity of the color formed is directly proportional to the amount of glucose present in the sample. Glucose + O 2 + H 2 O −−− in the presence of glucose oxidase enzyme Gluconic acid+ H 2 O 2 H 2 O 2 + 4 −aminoantipyrine + phenol −−− in the presence of peroxidase enzyme quinonimine +H 2 O Red colour (chromogen) Sample Glucose kit is used for the determination of glucose in serum, plasma and CSF. Samples usually taken are Serum, Heparinised plasma, EDTA plasma. Procedure a) Take Three Test tubes mark them “T” for Test “S” for Standard and “B” for Blank b) Take 1 ml of Glucose Reagent in all test Tubes c) Put 10ul serum in Test tube T d) Put 10ul Standard solution in test tube S e) Put all test tubes in water bath for 5 min at 370 C f) Measure the absorbance of the standard and samples against the reagent blank at 546nm wavelength Calculation Glucose concentration = Absorbance of sample Absorbance of standard X concentration of standard
Glucose level in different circumstance 60-100 mg/dl Normal Glucose fasting (BSF) 150 − 170 mg/dl Border line Hyperglycemia 180 mg/dl and above Diabetes Mellitus 100−150 mg/dl. Normal Blood Sugar Random (BSR) < 140 mg/dl. 2 Hour Post−Prandial Sugar Level Figure showing the regulation of glucose in the body.
WHO criteria for diagnosis of diabetes mellitus; Fasting: > 126 mgƒdl OR 7.0 mmol/l 2 hour post glucose load : > 200mgƒdl OR 11.1 mmol/l Important Viva Questions: Q1. What is renal threshold for glucose? what is its normal value? Q2. What is glycosuria? Q3. What is diabetes mellitus? Q4. Define TmG (Transport maximum for glucose)?
Q5. Which hormones are hyperglycemic in nature? Q6. What are the causes of hyperglycemia and hypoglycemia? Q 7. What is meant by blood sugar random and Post−Prandial? Q8. Which hormones regulate the blood glucose level? How? Teacher’s signature Date / /
Calculation Glucose concentration = A sorbance of sample Absorbance of standard X concentration of standard Normal Value of glucose in OGTT: Time Value of glucose Zero (fasting) 60−100mgƒdl (65−110mgƒdl max) After ½ an hour 110−140mgƒdl (100−150mgƒdl) After 1hour Upto 140 or max 150mgƒdl After 1 ½ 110 − 120 mgƒdl After 2 hours 65 − 110 mgƒdl Two hours post−prandial blood sugar (2 hr PP) means blood glucose level two hours after taking a meal, whereas postprandial simply means after a meal. GTT is normal if; ✓ Fasting plasma glucose is less than 110 mgƒdl ✓ Peak plasma glucose is less than 160 mgƒdl ✓ 2hr plasma glucose is less than 140 mgƒdl ✓ Urine glucose is absent
Impaired Glucose Tolerance: ✓ Fasting plasma glucose is less than 126 mgƒdl ✓ Peak plasma glucose is less than 199 mgƒdl ✓ 2hr plasma glucose is between 140 − 199 mgƒdl ✓ Urine glucose may be absent or present